MEDICARE: DR. MYRIAM ZAHYDEE ALLENDE-VIGO MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RE0101X	Endocrinology, Diabetes & Metabolism Physician	4962	PR

General Provider Information

NPI Number	:	1073517355
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MYRIAM ZAHYDEE ALLENDE-VIGO MD

Provider Business Mailing Address
First Line	:	PO BOX 364246
Second Line	:
City	:	SAN JUAN
State	:	PR
Zip	:	00936-4246
Country	:	US
Telephone Number	:	787-852-5313
Fax Number	:	787-765-9183

Provider Business Practice Location Address
First Line	:	18 J. FRANCESCHI ST.
Second Line	:	URB. PEREYO
City	:	HUMACAO
State	:	PR
Zip	:	00791-3948
Country	:	US
Telephone Number	:	787-852-5313
Fax Number	:	787-765-9183

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/02/2005
Last Update Date	:	01/07/2013

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